IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


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Fhotograiiik; 

Sciences 

Corporalion 


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23  WIST  MAIN  STRKT 

wntTH,N.Y.  usao 

(7U)S73-4S03 


CIHIVi/ICMH 

Microfiche 

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CIHJVi/ICiVIH 
Collection  de 
microfiches. 


:; 


Canadian  Inatituta  for  Hiatorical  Microraproductiona  /  inatitut  Canadian  da  microraproductiona  hiatoriquaa 


),'/ 


Technical  and  Bibliographic  Notas/Notes  tachniqua*  at  bibliographlquaa 


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modification  dans  la  m*thode  normaie  de  filmage 
sont  indiquAs  cl-dessous. 


Tl 
tfl 


Tl 

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fil 


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Coloured  covers/ 
Couverture  de  couieur 


I      I    Covers  damaged/ 


D 


D 


□ 


a 


Couverture  endommag*e 

Covers  restored  and/or  laminated/ 
Couverture  restaur6e  et/ou  pellicul*e 


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mais,  lorsqua  cela  *tait  possible,  ces  pages  n'ont 
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D 
D 
D 


D 
0 
D 
D 
D 
D 


CoiourecL  pages/ 
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obtenir  la  meiiieure  imege  possible. 


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Til 

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Additional  comments:/ 
Commentaires  supplAmantairas; 


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Ce  document  est  film*  au  taux  de  reduction  indiqui  cl-dessous. 


10X 


14X 


18X 


22X 


28X 


30X 


7 


12X 


10X 


2DX 


24X 


28X 


n 


32X 


Th«  copy  filmad  h«r«  has  b««n  r«produc«d  thanks 
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L'sxemplairo  film*  f ut  roproduit  grice  A  la 
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Library 
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Bibliothiqua 
Agricultura  Canada 

Las  imagas  suivantas  ont  AtA  raproduitas  avac  la 
plus  grand  soin,  compta  tanu  da  la  condition  at 
do  la  nattat*  da  I'axampiaira  film*,  at  an 
conformity  avac  las  conditions  du  contrat  da 
filmaga. 


Original  copias  in  printad  papar  covars  ara  filmad 
baginning  with  tha  front  covar  and  anding  on 
tha  last  paga  with  a  printad  or  illustratad  impras- 
sion,  or  tha  back  cover  whan  appropriate.  All 
othar  original  copias  ara  filmed  baginning  on  the 
first  paga  with  a  printed  or  illustratad  impres- 
sion, and  anding  on  the  last  page  with  a  printed 
or  illustrated  impression. 


Les  exemplaires  originaux  dont  la  couvarture  en 
papier  est  imprimte  sont  filmte  en  commenpant 
par  la  premier  plat  at  en  terminant  soit  par  la 
darnlAre  page  qui  comporte  une  emoreSnte 
d'Impression  ou  d'illustration,  soit  |;dr  la  second 
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originaux  sont  filmAs  en  commengant  par  la 
pramlAre  page  qui  comporte  une  empreinte 
d'Impression  ou  d'illustration  at  en  terminant  par 
la  darnlAre  page  qui  comporte  une  telle 
empreinte. 


The  lest  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  — ►  (meaning  "CON- 
TINUED"), or  the  symbol  y  (meaning  "END"), 
whichever  applies. 


Un  dee  symboles  suivants  apparattra  sur  la 
darnlAre  image  de  cheque  microfiche,  selon  ie 
ces:  Ie  symbols  -^  signlfie  "A  SUIVRE",  ie 
symbols  y  signlfie  "FIN". 


Maps,  plates,  charts,  etc.,  mey  be  filmed  at 
different  reduction  retios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  dixt^fams  illustrate  the 
method: 


Les  cartes,  plenches,  tableaux,  etc.,  peuvent  Atre 
filmte  A  des  taux  de  reduction  diff Arents. 
Lorsque  ie  document  est  trop  grand  pour  Atre 
reproduit  en  un  seul  clichA,  il  est  film*  A  psrtir 
de  Tangia  supAriaur  gauche,  de  gauche  A  droite, 
et  de  haut  en  bas,  en  prenent  Ie  nombre 
d'images  nteesssire.  Les  diagrammes  suivants 
illustrent  Ie  m^thode. 


1 

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/ 


'  '^»»- J 


MUSHROOM  POISONING 


BEAUMONT  SMALL. 

OTTAWA. 


kbprinted  prom 

Twentieth  Century  Practice  of  Medicine 

Vol.  XX. 


NEW  YORK 

WH,I,IAM  WOOD  AND  COMPANY 

POBLISHBRS 

IMO. 


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•  » 


I 


MUSHROOM  POISONING. 


BY 


BEAUMONT  SMALL, 


OTTAWA. 


■ 


MUSHROOM  POISONING. 


The  subject  of  mushroom  poisoning  is  of  much  importance  to  the 
practising  physician,  who  may  at  any  moment  be  called  upon  to  care 
for  such  a  case.  In  Europe,  where  fungi  are  articles  of  every -day 
diet,  accidents  are  conntantly  occurring  from  the  mistaken  use  of 
poisonous  species.  In  America  this  form  of  food  is  nob  utilized  to 
the  same  extent,  and  cases  of  poisoning  are  not  so  frequent ;  but  very 
severe  illnesses  and  deaths  do  occur  from  this  cause,  and  an  autumn 
rarely  passes  without  some  such  case  being  referred  to  in  our  medical 
publications.  In  some  instances  it  is  duo  to  the  gathering  of  poison- 
ous forms  with  the  common  mushroom.  At  other  times  it  arises 
from  the  desire  to  gather  species  that  are  not  so  well  known ;  and  oc- 
ci-sionally  we  find  that  the  attractive  appearance  of  the  poisonous 
forms  has  tempted  a  child  to  gather  and  eat.  In  works  upon  this 
subject  very  many  cases  are  reported,  and  the  large  percentage  of 
deaths  is  noticeable.  Ziemssen  quotes  the  cases  of  a  mother  and 
daughter,  both  fatal ;  of  a  mother  and  child,  both  fatal ;  of  five  officers, 
all  of  whom  died;  of  a  family  of  seven,  with  three  deaths.  Blyth  re- 
fers to  the  statistics  of  fifty-three  cases  of  poisoning  by  Amanita  phal- 
loides,  of  which  forty  ended  in  death.  * 

The  earlier  reports  of  cases  are  generally  very  imperfect  and  brief, 
and  many  of  the  more  recent  ones  have  the  same  deficiency .  Others, 
however,  are  very  carefully  and  minutely  reported  and  are  valuable 
contributions  to  the  subject. 


Illustrative  Cases. 


The  following  are  a  few  illustrative  cases : 

Two  adult  males  ate,  at  8 :30  a.m.,  at  breakfast,  a  quantity  of  mush- 
rooms supposed  to  be  Amanita  ca'sai-ea,  but  in  reality  A.  muscaria. 

The  first  man  ate  about  two  dozen.  At  8:45  he  complained  of 
feeling  unwell,  and  at  nine  was  found  on  his  bed  in  a  state  of  collapse. 
He  complained  of  a  sense  of  impending  death,  and  there  rapidly  su- 
pervened blindness,  trismus,  difficulty  in  swallowing,  unconscious- 
ness, and  convulsions.  Death  took  place  in  the  evening  of  the  second 
day.  The  treatment  consisted  in  the  administration  of  emetics,  and 
apomorphine  and  atropine  hypodermically. 


r)42 


SMALL— MUSHROOM  POISONINO. 


The  second  man  ate  about  one  dozen.  After  breiikfast  lie  rode  to 
liiH  office.  At  9:80  he  be^au  to  coinphiin  of  diplopia  and  drowHiuesH. 
At  ten  o'clock  he  was  found  wittiuj^  in  his  chair,  half  stupid,  with  re- 
traction of  the  head.  He  rapidly  became  uncouHciouH  and  remained 
so  for  five  hours,  excepting  ui)on  two  occasions,  when  he  regained 
consciousness  for  a  brief  i)eriod.  Cold  sweats  were  a  prominent 
symptom.  There  was  no  rise  in  temperature,  no  pain,  nor  any  nau- 
sea. The  treatment  consisted  in  the  hypodermi<i  administration  of 
apomorphine,  which  was  of  no  effect.  Strychnine  and  atropine  were 
then  given;  of  the  latter,  gr.  ^'i.  every  two  hours,  about  gr.  /,»  being 
given  in  the  twenty-four  hours.  Castor  oil  and  sweet  oil  were  also 
given.     The  man  recovered. ' 

A  boy,  aged  12  years,  ate,  at  11:30  a.m.,  about  one-third  of  the 
pileus  of  an  Amanita  phalhides.  No  ill  effects  were  felt  until  1 
A.M.,  when  he  awoke  complaining  Of  thirst,' which  was  followed  by 
vomiting  and  purging.  These  symptoms  continued  all  night,  and 
less  severely  during  the  day.  Castor  oil  and  citrate  of  magnesia  weye 
given.  The  following  morning  he  awakened  with  severe  abdominal 
pain,  and  when  seen  by  the  ])hysician  he  was  feverish  and  suffering 
from  palpitation,  purging,  vomiting,  and  extreme  exhaustion.  A 
mixture  of  chloroform,  morphine,  and  cardamoms  was  given;  also 
whiskey.  The  symptoms  eased  during  the  day,  but  the  prostration 
continued.  He  slept  the  following  night,  but  about  7  a.m.  was  seized 
with  convulsions  and  died  in  half  an  hour,  on  the  fourth  day  after 
eating  the  fungus.  The  post-raortem  examination  was  made  thirty- 
six  hours  after  death  Rigidity  was  well  marked,  the  face  was  cy- 
anotic, and  dark-brown  fluid  was  issuing  from  the  mouth  and  nos- 
trils. Upon  opening  the  abdomen,  marks  of  recent  peritonitis  were 
seen  as  bands  of  lymph  gluing  the  small  intestines  together.  The 
stomach  contained  a  small  amount  of  dark  fluid,  the  mucous  mem- 
brane was  inflamed,  and  the  walls  were  softened.  The  whole  of  the 
small  intestine  was  inflamed  and  there  were  numerous  spots  of  gan- 
grene. The  liver  was  ansemic,  the  heart  was  empty,  and  the  lungs 
were  healthy." 

Mrs.  N ,  aged  55  years,  ate  a  third  of  a  raw  mushroom,  prob- 
ably A.  phalloides,  about  10  a.m.  No  symptoms  appeared  until  7 
P.M.,  after  supper,  when  abdominal  cramps  commenced  and  steadily 
increased  in  severity.  Vomiting  began  at  8  p.m.,  with  marked  pros- 
tration. The  patient  was  found  in  a  condition  of  collai)se,  with  a  tem- 
perature of  100.5°  F. ;  pulse  small,  rapid,  weak;  respirations  shal- 
low; slight  tympanites  and  abdominal  tenderness;  the  pupils  were 
contracted;  there  were  cold  perspirations,  pallor,  and  an  anxious, 
drawn  expression,  with  mild  delirium,  intense  retching,  and  profuse 
»vatery  stools.  Treatment:  morphine  sulphate  gr.  i,  atropine  nitrate 
gr.  jf,y,  strychnine  nitrnte  gr.  j\;  and  hourly,  fluid  extract  of  bella- 
donna gtt.  i.,  fluid  extract  of  nux  vomica  gtt.  ss.,  bismuth  subnitrate 
gr.  ij. ;  after  every  emesis,  sodium  bicarbonate  3  ss.  in  half  a  glass 
of  water;  whiskey  ad  libitum,  and  hot  applications.  From  12  p.m. 
the  symptoms  gradually  subsided.  The  treatment  was  continued  for 
two  days.^ 

Five  persons,  aged  13,  22,  29,  40,  and  45  years,  ate  of  what  was 


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probnV)ly  Amninta  vcrnn,  ])rppared  as  u  Htew,  at  nine  o'clock  in  the 
evening,  five  hours  "fter  the  fungi  had  biien  gutliered.  No  discom- 
fort was  exi)erienceil  until  towards  morning,  when  all  were  attacked 
with  pain  in  the  stomucli,  nausea,  and  a  sickening  sensation  at  the 
epigastrium.  Twelve  hours  after  the  nmshrooms  had  been  eaten  all 
the  symptoms  had  increased  in  severity,  and  in  addition  there  were 
retching  and  vomiting.  In  thirty  hours  theri^  was  intense  gastro- 
enteric irritation  with  relaxed  bowels  and  distressing  tenesmus.  As 
these  symptocin  subsided  they  were  followed  by  prostration,  cokl- 
ness  of  the  suvface,  and  a  tendency  to  coma.  In  two  of  the  jiatients 
who  had  eiden  more  than  the  others  the  symptoms  advanced  to 
coma  and  coma  vigil,  with  tlie  features  shrunken,  skin  dusky,  and 
pulse  scarcely  percei)tible.  One,  aged  thirteen  years,  died  in  fifty -six 
hours;  another,  aged  twenty-two  yejirs,  in  sixty -three  hours.  The 
treatment  consisted  in  the  administration  of  bismuth  and  creosote, 
morphine,  stimulants,  heat  to  the  surface,  and  atrojune.  The  atro- 
l)ine  was  not  begun  until  twenty -four  hours  had  elapsed ;  it  was  given 
in  repeated  small  doses  until  each  patient  had  had  res])ectively  ^V» 
A,  uV,  a\),  and  i;',,  of  a  grain.  Temporary  improvement  was  noticed 
after  each  dose  of  the  antidote.^ 

Father,  mother,  and  child,  aged  5  years,  ate  twelve,  eight,  and 
five  mushrooms  respectively,  sup[)OHed  to  be  Ainanitn  imiararin,  Ama- 
nita phalloidcs,  and  Amanita  verna.  They  were  gathered  during  the 
morning  and  eaten  at  dinner.  Nausea  and  headache  were  comi)lained 
of  during  the  afternoon.  At  six  o'clock  more  were  eaten.  The  same 
symptoms  were  noted,  but  in  greater  intensity.  At  midnight  purg- 
ing and  vomiting  became  severe,  but  there  was  not  much  pain,  ex- 
cepting cramps  in  the  legs.  The  vomiting  at  first  consisted  of  food ; 
then  it  became  choleraic,  as  also  did  the  stools,  and  finally  of  a  pink 
or  purplish  color.  In  twenty-four  hours  the  patients  became  jaun- 
diced and  had  a  peculiar  glazed  ai)])earauce  about  the  eyes.  Muscu- 
lar twitchings  took  i)lace,  esj^ecially  in  the  face,  arms,  and  hands. 
During  the  next  twelve  hours  the  depression  became  severe,  the  heart 
was  irregular,  the  respirations  were  jerky,  and  the  pui)ils  were  di- 
lated. The  urine  became  saffron-colored,  and  before  death  it  was 
purplish.  The  perspiration  and  breath  smelled  of  mushrooms.  In 
forty-eight  hours  the  mother  and  child  died  within  half  an  hour  of 
one  another.  The  child  had  convulsions  for  about  four  hours,  up  to 
two  hours  before  death.  The  mother  was  restless  and  unconscious 
about  five  hours  before  death.  The  father  recovered  in  about  twelve 
hours  after  the  symptoms  had  commenced.  Treatment  consisted  of 
morphine  gr.  |,  atropine  sulphate  gr.  j^^,  repeated  in  two  hours; 
whiskey,  ammonia,  and  nitroglycerin.** 

A  nan,  aged  52  years,  ate  of  an  omelet  prepared  from  mush- 
rooms, among  which  were  Amanitn  phalloidea  and  Boletus  luridus. 
Four  hours  after  eating  he  was  found  covered  with  a  cold,  clammy 
perspirfvtion ;  the  breathing  was  stertorous  and  of  the  Cheyne-Stokes 
type;  the  pulse  was  almost  imperceptible — 28  per  minute.  The  pu- 
pils were  dilated.  Atropine  was  given;  also  ether,  coffee,  and  rum; 
and  heat  was  applied  to  the  surface.  The  symptoms  continued  to 
grow  worse  until  one  litre  of  decinormal  saline  solution  was  injected. 


I 


644 


SMALL— MUHHROOM   POIHONINO. 


Iiiiproveineiit  followed  iiiim(>(li>it(>l,v ;  thiH  trcMitinout  w»h  continued, 
and  in  on(>  hour  tho  pulHo  wuh  (iO  \}or  minute,  the  rtmpimtiou  iM^oinio 
sti'oU|,{er,  and  the  putient  nillied  from  the  Htate  of  collupHe.  No  diur- 
rh(L'a  or  vomiting  whh  present  Jit  uu.v  time." 

The  PoisonouB  Principles  in  Mushrooms. 

The  poisonous  i)r()perties  of  fungi  and  the  active  principles  that 
produce  the  poisonous  eff(M*ts  have  received  much  attention  fronj 
many  careful  observers.  For  manv  years  a  principle  common  to  all 
8[)ecies  was  Hought  for,  and  various  cluunists  described  several  poisons 
under  as  many  titles.  Thus  we  have  had  miiHcnriHC,  hitlhoHuu',  attitni- 
Ifin,  (ujdvicin,  iKjaryih'nx',  and  many  others.  At  present  all  are  re- 
solved into  two  poisons,  vinHcaruic  and  />/Kilfiit,  the  former  char- 
acteristic of  Amanita  muscaria,  being  an  alkahnd ;  the  latter  charac- 
teristic of  Amanita  phalloiden  and  an  entirely  dift'erent  ])oisou. 

In  addition  to  the  action  oi  poisonous  species,  very  many  instances 
of  poisonous  effects  have  followed  the  use  of  species  which  are  known 
to  be  free  from  any  [)<)isouous  pro2)erties.  Most  of  these  were  un- 
doubtedly due  to  gastrointestinal  irritation,  more  or  less  severe,  in 
some  cases  leading  to  peritonitis.  All,  however,  cannot  be  traced  to 
this  condition,  and  in  sf)me  cases  the  poisoning  has  been  popularly 
explained  by  the  fact  that  the  edible  form  was  gathered  from  a  manure 
heap  or  from  some  other  deconii)osing  organic  matter,  which  produced 
a  poisonous  action.  Another  exi)lauation  is  that  the  mushroom  may 
have  been  kept  too  long,  and  that  decomposition  and  putrefactive 
changes  had  begun  which  rendered  it  poisonous  in  character.  In 
the  light  of  modern  bacterial  science,  this  idea  of  a  toxic  jninciple 
being  generated  by  the  decomposing  mushroom  is  of  much  import- 
ance. We  know  that  many  cadaveric  jioisons  are  produced  in  this 
way,  and  we  also  know  that  the  mushroom  has  been  termed  a  "  vege- 
table beefsteak"  on  account  of  the  very  large  percentage  of  nitrogen- 
ous matter  in  its  composition.  The  flesh  of  the  mushroom,  in  addi- 
tion to  a  large  j)ercentage  of  water,  about  eighty  per  cent.,  is  made  up 
of  a  proteid  or  nitrogenous  substance  called  fmigin,  which  contains 
from  3.2  to  7.2  jier  cent,  of  nitrogen.  It  is  to  this  fungin  that  the 
mushroom  owes  its  highly  nutritive  properties. 

Muscarine,  CjH,,,NO„  the  most  carefully  studied  and  best  known 
of  the  poisonous  jmnciples,  is  an  alkaloid,  first  described  by  Schmiede- 
berg  and  Koppe,'  whose  investigations  form  the  foundation  for  our 
present  knowledge  of  this  subject.  Their  work  ^as  been  confirmed 
by  others  (I.  L.  Prevost")  and  reaffirmed  by  Schniiedeberg." 

It  is  a  colorless,  syrupy  fluid,  tasteless  and  without  odor.  It  is 
very  soluble  in  water  and  alcohol,  but  insoluble  in  ether;  very  slightly 


I 


THE  POISONOUS  PRINCIPLES  IN  MUfiUnoOMH. 


645 


atinued, 

Iwcjiine 

No  diar- 


pleH  that 
Lou  fi<>»u 
lon  to  all 

il  po'lHOUrt 

lie,  nnnni- 
ill  aro  ro- 
mer  char- 
er  I'lmrac- 

iaou. 

y  iuHtanceH 
uro  kuown 
le  ^vel•e  un- 
\  Hever(>,  in 
le  traced  to 
1  popularly 
m  a  mauure 
3h  produced 
broom  may 
putrefactive 
iracter.    lu 
:ic  principle 
Qch  import- 
uced  in  this 
led  a  "  vege- 
of  nitrogen- 
om,  in  addi- 
,  is  made  up 
lich  contains 
igin  that  the 

best  known 
)ySchmiede- 
ition  for  our 
3n  confirmed 

erg." 
odor.     It  18 
very  slightly 


soluble  in  chloroform.  It  is  alkaline  in  reaction  and  combines  with 
acids  to  form  salts.  The  suli)hate  and  nitrate  are  prepared  for  com- 
merce.    They  are  very  hygroscopic  and  solub'o  in  water  and  alcohol. 

The  quantity  of  musotiriue  present  in  the  fungus  has  not  l)een  de- 
termined. It  has  l)een  estimated  variously  from  one-fifth  to  one  per 
cent,  of  the  dried  fungus.  The  i)ercentage  varies  greatly  according 
to  the  season  of  the  year,  the  locality  in  which  it  grows,  and  many 
such  conditions. 

Muscarine  was  formerly  considered  to  be  characteristic  of  the  fly 
agaric  and  similar  fungi,  but  in  the  progress  of  chemical  and  bacterial 
science  it  has  been  obtained  from  other  and  very  diffeiv.::t  sources.  It 
has  been  separated  as  a  ptomain  from  decomi)osing  fish  and  also 
from  horseflesh  undergoing  the  same  change  (Vaughu..  ).  It  is  also 
prepared  synthetically  from  choliu  by  the  oxidizing  acti(m  of  nitric 
acid.  Cholin,  ueurin,  and  other  ptomains  to  which  it  is  allied  are  all 
of  cadaveric  origin,  and  nearly  all  are  powerful  poisons.  The  phys- 
iological action  of  muscarine  bears  a  resemblance  to  that  of  pilocar- 
pine, and  also  of  calabar  bean.  It  is  primarily  an  excitant  to  the  nerve 
centres,  the  period  of  excitement  rapidly  passing  into  one  of  depres- 
sion. Upon  the  brain  it  is  an  intoxicant,  causing  dizziness,  vertigo, 
confusion  of  ideas,  delirium,  disturbed  vision,  ataxia,  and  other  like 
symptoms,  which  may  end  in  convulsions,  coma,  paralysis,  and 
death.  Its  depressing  action  is  specially  directed  to  the  cardiac  and 
respiratory  centres,  and  its  fatal  effects  are  due  to  paralysis  of  these 
organs.  The  heart  remains  in  a  dilated  state  after  death.  The  vaso- 
motor centres  are  also  depressed,  causing  a  lo>Vering  of  the  blood 
pressure.  It  increases  the  secretion  of  the  sudoriparous,  lacry- 
mal,  salivary,  and  all  other  glands,  probably  witli  the  excei)tion  of 
the  kidney.  The  muscular  system  is  also  irritated  and  weakened, 
giving  rise  to  muscular  fatigue  and  cramps  of  the  extremities  and  of 
the  intestines.     The  pupils  are  contracted. 

The  action  of  atropine  upon  Ihe  heart  is  directly  antagonistic  to 
muscarine,  and  furnishes  us  with  the  physiological  and  most  valuable 
antidote.     Atropine  paralyzes  the  inhibitory  nerves  of  the  heart  and 
[increases  the  rapidity  of  its  action.     The  effect  of  muscarine  is  to 
produce  a  slowing  and  weakening  of  its  action.    The  opposing  effect 
lis  frequently  demonstrated  upon  the  exposed  heart,  which,  when  fail- 
ling  from  the  presence  of  muscarine,  is  at  once  aroused  into  action 
[by  a  drop  of  atropine  solution,  or,  if  the  atropine  has  been  first  ap- 
[plied,  the  toxic  effect  of  muscarine  is  prevented. 

No  cases  of  poisoning  by  pure  muscarine  have  been  reported. 
[All  our  knowledge  is  derived  from  experimental  work  upon  animals 
land  man.     It  has  been  found  that  8  to  12  mgm.   (gr.  |  to  \)  will 
Vol.  XX.— 35 


T^ 


546 


SMALL— MUSHllOOM  I'OISOKING. 


cause  the  death  of  a  cat  in  about  eighteen  miuutes,  and  3  to  4  mgm. 
(gr.  5^  to  -^g)  will  have  the  same  result  in  a  few  hours.  Five  milli- 
grama  (gr.  /j)  taken  by  an  adult  man  causes  in  a  few  minutes  pro- 
fuse salivation  and  lacrymation,  increased  freiiuency  of  pulse,  nausea, 
giddiness,  confusion,  determination  of  blood  to  the  head,  and  perspira- 
tion. There  is  no  vomiting  or  diarrhoea.  Fatal  doses  in  cats  cause 
salivation,  contraction  of  pupils,  vomiting  and  purging,  rapid  breath- 
ing, and  dysjmoea;  as  death  approaches  the  respirations  grow  slower, 
iue  i)upils  become  dilated,  and  convulsions  usher  in  death. 

The  poisonous  lu'inciple  ol  Amanita  phalloidcs  has  been  frequently 
investigated,  and  the  poison  obtained  has  been  variously  named. 
Biilhosin,  amanitui,  phalloidln,  and  several  others  have  been  described, 
but  no  satisfactory  result  was  reached  until  Kobert ' '  i)ublished  the 
results  of  his  researches  and  named  the  poison  phallin.  Phallin  is 
an  entirely  diflferent  poison  from  muscarine.  It  is  a  toxalbumin,  a 
member  of  that  group  to  which  belongs  the  specific  poison  of  cheese, 
meat,  rattlesnake  i)oison,  as  well  as  the  toxic  agent  of  diphtheria  and 
other  bacterial  poisons. 

Tlie  action  of  phallin  is  directed  to  the  blood  corpuscles,  causin, ; 
their  destructiijn  and  setting  free  the  hajmoglobin.  It  produces  such 
changes  in  the  ])lasma  that  the  serum  escai)es  from  the  vessels  into 
the  various  tissues  and  cavities,  and  a  condition  resembling  i}vA  pro- 
duced by  cholera  is  the  result.  Its  action  is  slow,  and  the  symi)tom8 
of  poisoning  do  not  appear  for  an  interval  of  from  three  or  four  to 
twelve  or  fourteen  hours.  They  begin  as  severe  abdominal  ])aiu, 
prostration,  vomiting,  free  watery  evacuations,  and  symptoms  of  col- 
lai)se.  Irritation  to  the  nervous  system  is  shown  by  muscular  cramps, 
tetanic  in  character,  and  convulsions.  Consciousness  usually  remains 
unaffected.  The  i)ulse  becomes  weak  and  flabby.  The  kidneys 
secrete  much  less  urine,  and  there  are  signs  of  albuminuria  and 
luemo^Iobinuria. 

The  presence  of  this  second  poison  ex] plains  the  symptoms  of 
many  cases  of  poisoning  that  were  obscuie  when  muscarine  was  con- 
sidered the  sole  poisonous  principle  of  mushrooms.  At  present  A. 
mnscdvia  and  A.  panihevoidt'H  have  been  studied  as  the  source  of 
muscarine  only,  and  A.  pludloidcs  alone  has  furnished  pliallin,  but  it  is 
not  i)robable  that  either  poison  is  limited  to  these  particular  8i)ecies. 
There  is  much  more  reason  to  believe  that  each  jioison  is  widely  dis- 
tributed. MuHcarine  is  certainly  the  chief  poison  of  A.  muacana, 
bat  many  of  the  symptoms  that  follow  poisoning  by  this  fungus  can 
be  explained  only  by  the  i)roKeuce  of  phallin. 


I 


CI 


SYMPTOMS. 


547 


4mgm. 
e  milU- 
ies  pro- 
nausea, 
lerspira- 
,t9  cause 
1  breath- 
jv  slower, 

requently 
y  uauieil. 
lescribed, 
iaiied  the 
Phallin  is 
Llbumin,  a 
of  cheese, 
theria  and 

B9,  causin,; 
(luces  such 
vessels  into 
ig  tV.^'t  pro- 
s  symptoms 
e  or  four  to 
niual  pain, 
;oms  of  col- 
ilar  cramps, 
(lly  remains 
|he  kidneys 
pinuria  and 

^■mptoms  of 
tue  was  con- 
present  A. 
\q  source  of 
jlUn,  butitis 
Liar  species, 
widely  dis- 
miisecwia, 
fungus  can 


Pathological  Anatomy. 

The  post-mortem  ai)pearances  are  not  very  definite.  By  some  it 
is  stated  that  rigor  mortis  is  absent.  Others  have  found  it  to  exist, 
but  to  disappear  early.  There  are  evidences  of  gastrointestinal  irri- 
tation, and  portions  of  the  fungus  may  be  present.  The  various 
organs  are  congested,  especially  the  kidneys.  The  abdominal  and 
])leural  cavity  may  contain  lluid  colored  by  the  transuded  hfomoglo- 
bin.  The  heart  is  dilated.  In  a  series  of  autopsies,  when  death 
probably  resulted  from  phallin  poisoning,  there  were  numerous  small 
ecchymoses  on  the  pleural  surfaces,  and  also  in  the  lungs,  heart,  kid- 
neys, liver,  and  other  organs.  The  blood,  also,  '"as  found  to  be  of  a 
dark  cherry-red  color  and  fluid.  The  veins  were  full.  Fatty  degen- 
eration of  the  liver  has  been  found  in  some  cases. 

Symptoms. 

The  symptoms  that  follow  tlie  use  of  poisonous  fungi  coincide 
with  tlie  results  of  tlie  experimental  work  with  these  poisons.  In  the 
majority  of  cases  the  symi)toms  are  distinctly  those  of  one  or  the 
other  poison,  sometimes  complicated  by  the  irritation  of  undigested 
portions  of  the  fungus.  In  poisoning  by  muscarine  the  diagnostic 
iwints  are  the  early  onset  of  symptoms,  the  signs  of  intoxication,  and 
the  functional  weakness  of  the  heart  and  lungs.  In  i)oisoning  by 
phallin  the  symptoms  are  delayed;  there  is  an  absence  of  cerebral 
disturbance,  .and  severe  gastroenteric  irritation,  becoming  choleraic 
in  character,  is  the  prominent  symptom. 

In  nmscarine  i)oisoning  the  alkaloid  is  very  stable  and  is  excreted 
with  the  urine,  which  retains  the  intoxicating  properties.     This,  it  is 
eported,  the  inhabitants  of  certain  districts  of  Siberia  take  advantage 
f  in  order  to  prolong  their  intoxication.     The  fly  agaric  is  a  com- 
on  fuugns  in  northern  Asia,  and  furnishes  the  natives  with  a  sub- 
titute  for  the  alcohol,  o])ium,  and  the  narcotics  of  other  countries. 

The  duration  and  termination  of  cases  of  mushroom  poisoning 
ary  greatly  according  to  the  quantity  of  poisonous  material  taken  into 
10  system.  Tliey  are  also  influenced  by  the  health  and  strength  of 
10  patient.  Cases  due  to  muscarine  run  a  more  rai)id  course  than 
lose  due  to  phallin.  The  symptoms  begin  ahnost  at  once,  and  death 
ay  take  place  in  five  or  six  hours ;  more  frecpieutly  a  fatal  termina- 
on  does  not  take  i)lace  until  the  seccmd  or  third  day.  Convalescence 
always  slow,  more  ])articul}iily  in  severe  cases.  Wlien  pliallin  is 
10    poison,  the  course  is  slower.     Death  may  take  place  on  the 


548 


SMALL— MUSHROOM  POISONING. 


ijii 


second  day,  but  four  or  five  days  is  the  more  common  period.  In 
some  instances  the  ;)atient  has  lingered  seven  days.  Of  five  officers 
poisoned  by  eating,  A.  bulbosa,  symptoms  did  not  begin  until  eleven 
hours  had  elapsed ;  two  died  on  the  second  day,  two  on  the  third, 
and  one  on  the  fifth  day.  In  another  case  a  child  died  on  the  second 
day,  the  mother  on  the  fifth  day.  In  still  another  instance,  one  vic- 
tim died  .j'ter  forty-eight  hours,  one  at  the  end  of  sixty  hours,  and 
the  third  on  the  seventh  day. 


>i 


I       I 


Treatment. 

The  treatment  consists  of  measures  to  allay  the  gastrointestinal 
irritation  and  overcome  the  depression,  and  also  the  employment  of 
special  antidotes  to  counteract  the  poison.  ,  The  stomach  should  be 
emptied  as  rapidly  as  possible  for  the  purpose  of  removing  all  jjor- 
tious  of  the  fungi  that  may  remain  undigested.  Castor  oil  and  ene- 
mata  should  be  used  with  the  same  object  in  view;  milk,  barley 
water,  and  other  demulcent  drinks,  bismuth,  magnesia,  and  antacids 
are  to  be  given  for  the  double  i^urpose  of  soothing  the  irritated  mu- 
cous membrane  and  of  retarding  the  absorption  of  the  poison.  Mus- 
carine becomes  very  soluble  in  the  acid  fluids,  and  for  this  reason 
acids  should  not  be  given.  Alcohol  and  ammonia  may  be  required  to 
stimulate  the  heart  and  respiration  and  lessen  the  general  depression. 

As  special  antidotes,  tfinuin,  charcoal,  and  permanganate  of  potas- 
sium have  been  recommended.  The  first  two  are  ot  value  in  render- 
ing insoluble  the  poisons,  and  the  latter  for  the  i)urpose  of  decom- 
posing the  alkaloid;  their  value,  however,  is  as  yet  uncertain. 

When  the  poisoning  ii>  due  to  muscarine,  the  only  antidote  to  de- 
pend upon  is  atropine,  which  should  be  immediately  administered  in 
all  cases  of  suspected  i)oisoniug  from  this  source.  Experiments  have 
proved  conclusively  that  wlien  the  inhibitory  nerves  of  the  heart  are 
dejjressed  by  atropine  the  effects  of  muscarine  are  almost  entirely 
counteracted,  and  when  the  heart  and  respiration  are  failing  from  the 
poison,  the  atropine  helps  to  restore  their  tone  and  force.  In  the 
cases  in  which  it  has  been  employed,  even  when  death  has  finally 
taken  place,  its  favorable  effects  have  been  specially  mentioned.  It 
should  be  administered  hypodermically,  in  gr.  y),  „  to  -^^  doses,  re- 
peated hourly,  according  to  the  symptoms  and  its  effect. 

When  A.  phalloldes  has  been  taken  and  phallin  is  the  poisonous 
princii)le,  there  is  no  drug  that  can  be  employed  with  the  same 
feeling  of  hopefulness,  as  there  is  no  known  antidote  to  this  i)oison. 
As  soon  as  the  poisoning  is  suspected  the  same  general  treatment 
is  iudicHted  for  the  purpose  of  removing  any  portion  of  the  fungus 


^ 


CLASSIFICATION  OF  MUSHROOMS. 


649 


iod.  In 
B  officers 
;il  eleven 
he  third, 
16  second 
,  one  vic- 
ours,  and 


I 


)intestinal 
oymeut  of 
should  be 
ng  all  por- 
l  and  ene- 
ilk,  barley 
id  antacids 
•itated  mu- 
ion.     Miis- 
;his  reason 
required  to 
depression . 
te  of  potas- 
in  render- 
of  decom- 
ain. 

Ldote  to  de- 
inistered  in 
iraents  have 
10  heart  are 
ost  entirely 
Qg  from  the 
>e.    In  the 
has  finally 
tioned.     It 
u  doses,  re- 

a  poisonous 

^1  the  same 

^his  poison. 

il  treatment 

the  fungus 


and  preventing  further  absorption.  Stimulants  should  be  freely  ad- 
ministered. Nitrite  of  amyl  and  nitroglycerin  may  i)rove  of  service 
to  maintain  the  cutaneous  circulation.  When  the  severe  symi)tom8 
supervene  and  collapse  is  threatening,  intravenous  injections  of  deci- 
normal  saline  solution  or  its  subcutaneous  use  will  prove  of  great  ser- 
vice, and  upon  this  procedure  will  depend  the  greatest  hope  of  suc- 
cess.    Transfusion  of  blood  has  also  been  recommended. 

Classiflc!xtion  cf  Mushrooms. 

The  higher  forms  of  fungi  which  grow  so  j^rofusely  throughout 
the  whole  world  are  classified  into  tliree  groups,  according  to  their 
mode  of  producing  spores.     These  are — 

Hymenomyceiea',  in  which  the  spores  are  external  to  the  lining 
membrane,  which  membrane  is  o;i  the  under  surface  of  the  pileus  or 
cap  and  folded  as  gills.  This  comprises  all  such  as  are  commonly 
called  mushrooms  or  toadstools. 

Biscomycetece,  in  Avhich  the  spores  are  also  formed  external  to  the 
membrane,  but  in  depressions,  or  lacunsB,  on  the  upper  and  outer 
surface,  as  in  the  ordinary  morel. 

Gastromyceteaiy  in  which  the  spores  are  contained  in  a  cavity 
formed  by  the  membrane,  as  in  the  well-known  puff-balls. 

Of  the  many  thousand  species  that  are  included  in  these  three 
classes,  only  a  few  are  known  to  contain  an  active  poison,  and  nearly 
all  these  are  closely  allied  and  form  a  single  genus  of  the  hymenomy- 
cetesB.  The  most  important  of  the  many  generi  of  hymenomycetese 
are  Agaricus  and  Amanita.  The  former  contains  the  ordinary  edible 
mushrooms,  the  latter  the  poisonous  forms. 

These  genera  are  variously  arranged  by  different  botanists,  and 
this  want  of  uniformity  has  led  to  much  confusion  of  names.  For- 
merly all  were  included  in  the  single  genus  Agaricus,  and  we  will 
find  the  poisonous  forms  referred  to  as  Agaricus  muscaria,  etc.  It 
is  nov.  more  general  to  regard  the  Amanita  as  a  sub-genus,  or  as  a 
separate  genns,  with  its  distinctive  name. 

Distinction  between  Edible  and  Poisonous  Mushrooms. 

The  structural  and  botanical  differences  between  the  amanitas  and 
agarics  are  very  slight,  and  their  resemblance  is  the  cause  of  the 
many  accidents  that  occur.  Between  the  common  mushroom  and  the 
fly  agaric  the  difference  is  very  marked,  and  one  should  never  be  mis- 
taken for  the  other,  but  there  are  many  other  edible  mushrooms  that 
bear  a  close  resemblance.     The  danger  is  also  increased  by  the  fact 


.r 


650 


SMALL— MUSHROOM  POISONING. 


I'* 


H 


u 


Is 


that  certain  species  of  the  amanita),  as  A.  ca'sarea,  are  edible;  and 
unless  the  collector  is  a  skilled  mycologist  a  mistake  may  easily 
occur.  Man}'  suggestions  have  been  offered  to  facilitate  the  recog- 
nition of  the  poisonous  and  edible  species,  but  none  is  sufficiently 
trustworthy  to  be  depended  ui  on  without  some  knowledge  of  the 
distinctive  characters  of  each.  The  most  important  sign  is  the  pres- 
ence of  the  I'  ^Iva  which  is  formed  on  the  poisonous  species,  but  is 
absent  from  the  others.  When  young,  the  growing  fungus  is  envel- 
oped in  a  membrane,  which  is  ruptured  as  the  plant  expands,  its 
traces  remaining  as  a  cup-shaped  ring,  or  sheath,  around  the  base 
of  the  stem,  and  as  excrescences  on  the  upper  surface  of  the  cap. 
This  volva  is  often  below  the  surface  of  the  soil  and  is  easily  over- 
looked. In  gathering  the  fungus,  the  stem  is  generally  broken  off, 
and  the  characteristic  base  with  the  volva  is  left  behind.  The 
color  of  the  gills  is  also  suggestive,  those  of  the  edible  forms  being 
pinkish,  while  those  of  the  poisonous  species,  with  few  exceptions, 
are  white.  A  disagreeable,  noxious  odor  and  sharp,  acrid  taste  also 
indicate  a  dangerous  species. 

The  points  of  difference  between  the  common  edible  mushroom  and 
the  two  poisonous  forms  are  very  concisely  described  by  Dr.  W.  G. 
Far  low  of  Harvard  University,  as  follows: 

"  (1)  The  common  mushroom  has  a  pileus  which  is  not  covered 
with  wart-like  scales;  gills  which  are  brownish-purple  when  mature; 
a  nearly  cylindrical  stalk,  which  is  not  hollow  with  a  ring  near  the 
middle,  and  without  a  bulbous  base  sheathed  by  a  membrane  or  by 
scales. 

"(2)  The  fly  a«?aric  has  a  pileus  marked  with  prominent  warts; 
gills  always  white;  a  stalk,  with  a  large  ring  around  the  upper  part, 
and  hollow  or  cottony  inside,  but  solid  at  the  base,  where  it  is  bul- 
bous and  scaly. 

"  (3)  The  death  cup  has  a  pileus  without  distinct  warts,  gills 
which  are  always  white,  and  a  hollow  stalk,  with  a  large  ring,  and  a 
prominent  bulb  at  the  base,  whose  upi)er  margin  is  membranous  or 
bag-like. 

"  (4)  Other  points  of  difference  are  the  different  places  in  which 
these  species  grow,  and  also  the  colors,  which,  although  they  vary  in 
each  case,  are  brilliant  yellow  or  red  in  the  fly  agaric,  white  varying 
to  pale  olive  in  the  deadly  agaric,  and  white  usually  tinged  with  a 
little  brown  in  the  mushroom. 

"(5)  In  the  mushroom  the  pileus  averages  from  three  to  four 
inches  ixi  breadth,  and  the  stalk  is  generally  shorter  than  the  breadth 
of  the  pileus  and  comparatively  stout.  Ihe  pileus  remains  convex 
for  a  long  time,  and  does  not  become  quite  flat-topped  until  old. 


^ 


POISONOUS  MUSHROOMS. 


551 


lible;  and 
lay  easily 
the  recog- 
iufficieutly 
Ige  of  the 
1  the  prea- 
iea,  but  is 
IB  is  envel- 
:pau(ls,  its 
i  the  base 
)f  the  cap. 
sasily  over- 
broken  off, 
liud.     The 
Drms  being 
exceptions, 
I  taste  also 

shroom  and 
r  Dr.  W.  G. 

not  covered 

leu  mature; 

!g  near  the 

)rane  or  by 

uent  warts; 
upper  part, 
e  it  is  bul- 

warts,  gills 

ring,  and  a 

ibranous  or 

!es  in  which 

ihey  vary  in 

Hiite  varying 

[nged  with  a 

Iree  to  four 

the  breadth 

lains  convex 

[l  until  old. 


The  substance  is  firm  and  solid.  In  the  fly  agaric  the  pileus,  at  first 
oval  and  convex,  soon  becomes  flat  and  attains  a  breadlh  of  six  to 
eight  inches  and  sometimes  more.  The  stalk  has  a  length  ecpial  to  or 
slightly  exceeding  the  breadth  of  the  pileus,  and  is  comparatively 
slenderer  than  in  the  common  mushroom.  The  pileus  of  the  deadly 
agaric  is  thinner  than  that  of  the  mushroom,  and,  from  being  rather 
bell-shaped  when  young,  becomes  gradually  flat-tor)i.3d  with  the  cen- 
tre a  little  raised.  In  breadth  it  is  intermediate.  The  stalk  usually 
is  longer  than  the  breadth  of  the  i)ileus,  and  the  habit  is  slenderer 
than  the  other  two  species." 

The  special  characteristics  of  the  amanitas  are  as  follows :  "  Pileus 
(or  cap)  at  first  campanulate,  "then  plane ;  fleshy  towards  the  centre, 
attenuated  at  the  margin ;  gills  ventricose,  narrow  behind,  free,  nu- 
merous, at  length  denticulate,  the  imperfect  ones  few,  of  a  deter- 
minate form  according  to  the  kind,  and,  with  one  exception  (A. 
ctesareus),  white.  Stalk  generally  enlarged  at  the  base,  frequently 
bulbous,  solid,  or  stuffed  with  a  cotton-like  substance,  which  is  at 
length  absorbed ;  ring  descending,  imperfect,  fugaceous ;  flesh  white, 
unchanging"  (Badham). 

Poisonous  Mushrooms. 

The  following  species,  growing  in  this  country,  comprise  all  that 
are  known  constantly  to  possess  uctive  toxic  proi)erties.  There  are 
othfs  that  are  probably  poisonous,  but  as  yet  they  have  not  been 
properly  authenticated,  nor  have  any  deaths  been*  attributed  to  their 
use.  Many  of  them  often  produce  distressing  symptoms,  but  they 
are  uncertain  and  may  often  be  eaten  with  perfect  safety. 

Amanita  muscaeia  Grev.  Agaricus  muscaria  L.  Fly  agaric. 
This  is  a  large  showy  fungus,  very  common  in  some  localities,  grow- 
ing in  oak  and  pine  woods  from  June  to  late  in  the  autumn.  The 
pileus  is  of  an  orange  or  yellow  color,  sometimes  becoming  brilliant 
red,  in  others  it  varies  almost  to  a  white ;  it  is  covered  with  warty  ex- 
crescences, generally  whitish.  The  under  or  spore-i)roducing  surface 
is  white.  The  pla'^.t  is  very  free  from  insects  and  flies  and  does  not 
blacken  when  broken.  In  early  growth  the  pileus  is  convex,  but  be- 
comes flat  and  sometimes  concave.  The  stem  is  bulbous,  white,  and 
I  and  springs  from  a  volva.  It  is  rough  and  covered  with  warty  growths 
on  shaving-like  shreds.  It  should  be  readily  distinguished  from 
[  the  edible  species  by  its  color  and  appearance,  the  color  of  its  gills, 
!  and  its  place  of  growth,  as  it  is  never  found  in  meadows,  nor  does 
I  the  mushroom  grow  in  woods.  The  flj?  agaric  is  of  sturdy  growth, 
ranging  from  four  to  sixteen  inches  in  height.    Mistakes  are  more 


652 


SMALL — MUSHROOM  POISONINO. 


1  i 


t    i 


•'I ' 


liable  to  arise  in  mistaking  the  fly  agaric  for  some  of  the  edible  ama- 
nita,  us  Amanita  coisarea  and  Amanita  rubescans. 

Amanita  phalloides  (Pers.)  Fr.  Death  cup.  This  species  is  not 
so  large  nor  so  brilliant  as  the  A.  muscaria.  It  grows  from  three  to 
six  or  eight  inches  high,  and  is  found  in  woods,  but  often  extends 
into  meadows  and  fields.  It  may  be  gathered  in  summer  and  is  very 
common  in  the  autumn  months.  The  pileus  is  white  or  fawn-colored, 
sometimes  becoming  yellow  or  greenish  and  smooth,  and  the  invest- 
ing membrane,  separating  from  the  cap,  remains  as  a  deep  cup-like 
volva,  which  has  given  it  the  name  of  death  cup.  The  stem  is  white, 
or  tinged  in  the  darker  forms,  and  smooth,  excepting  when  the  invest- 
ing cap  is  closely  adherent,  when  it  has  a  bulbous  appearance.  It 
also  is  very  free  from  insects  and  remains  of  a  clear  color.  Its  odor 
and  taste,  when  fresh,  are  not  noticeable,  but  after  it  has  been  gath- 
ered they  become  disagreeable.     Its  gills  and  spores  Bre  white. 

This  species  is  likely  to  be  mistaken  for  the  common  edible  mush- 
room, but  it  bears  a  much  greater  resemblance  to  Lepiota  naucina, 
another  fungus  having  white  gills  and  spores,  but  quite  free  from  any 
poisonous  properties.  Another  source  of  danger  is  that  in  some  im- 
mature specimens  of  A.  phalloides  the  gills  are  of  a  faintly  pink  color. 

Amanita  verna  Bull.  The  vernal  or  bulbous  amanita  is  consid- 
ered by  many  to  be  simply  a  variety  of  A.  phalloides,  and  is  one  of  the 
most  important  of  the  poisonous  species  on  account  of  its  resemblance 
to  the  common  edible  mushroom.  It  is  smaller  than  A.  phalloides, 
more  delicately  formed,  and  of  a  pure  whit.e  color.  It  is  found  in  the 
early  summer  mouths  and  is  very  common  in  many  localities.  In 
Europe  it  appears  in  the  spring,  from  which  it  derives  its  specific 
name.  Its  distinctive  character  is  the  manner  in  which  the  sheath 
adheres  to  the  stem,  giving  the  stem  a  very  bulbous  appearance,  and 
depriving  it  of  its  cup-shaped  volva. 

Amanita  pantherinus  Deb.  is  a  common  species  with  many  va- 
rieties, lo  is  of  a  yellowish-brown  color,  over  which  there  are  many 
markings  of  a  darker  hue,  which  give  it  a  mottled  appearance.  The 
gills  and  flesh  are  white.  The  following  instance  of  poisoning  is 
quoted  by  Christison :  "  A  boy,  having  eaten  some  of  the  fungus,  be- 
came delirious  and  maniacal  and  gradually  passed  into  a  condition  of 
trance.     Recovery  took  place." 

Boletus  luridus  Schoeff.  This  fungus  is  of  a  different  class  from 
the  agarics  and  amanitas,  as  its  spores  are  formed  in  lacunae  on  the 
under  surface  of  the  pileus.  In  its  shape  it  resembles  the  agarics. 
The  upper  surface  varies  from  an  amber  to  a  brown  color;  the  under 
surface  and  stem  are  of  a  bright  red  or  ferruginous  brown.  The  flesh 
is  yellowish ;  when  broken  and  exposed,  it  changes  to  a  blue.     The 


BIBLIOGRAPHIOAL  REFERENOEB. 


658 


dible  aiua- 

)oie8  is  not 
m  three  to 
»n  extend^ 
and  is  very 
vn-colored, 
the  invest- 
ep  cup-like 
in  is  white, 
I  the  invest- 
arance.    It 
:.    Its  odor 
been  gath- 
nrhite. 

dible  mush- 
ota  naucina, 
ee  from  any 
in  some  im- 
f  pink  color, 
a  is  consid- 
is  one  of  the 
resemblance 
phalloides, 
'ound  in  the 
alities.     In 
its  specific 
the  sheath 
tarance,  and 


pileus  is  from  two  to  six  inches  broad.  The  stem  is  solid,  bulbous, 
sometimes  quite  smooth,  and  more  or  less  mottled.  It  grows  in 
woods  and  thickets. 

Bibliographical  References. 

1.  Prentiss:  Philadelphia  Medical  Journal,  September  24,  1898. 

2.  Plowright:  The  Lancet,  1879,  ii.,  p.  941. 

3.  Norris:  Philadelphia  McdicalJournal,  October  22,  1898. 

4.  Bhadle*:  Therapeutic  Gazette,  May,  1893. 

5.  Berry :  Philadelphia  Medical  .Journal,  September  24,  1898. 

6.  Delobel :  La  Presse  Medicale,  September  30,  1899  and  British  Medical  Jour- 
;    nal,  Epitome  52,  1900. 

I  7.  Schmiedebcig  und  Koppe:  Das  Muscarin,  das  giftige  Alkaloid  des  Fliegen- 

I    pilzes,  Leipsic,  1869. 

8.  Prevost .  Transactions  of  the  International  Medical  Congress,  1878. 

9.  Schmiedeberg :  Transactions  of  the  International  Medical  Congress,  1881. 

10.  Vaughan:  Twentieth  Century  Practice,  vol.  xiii.,  p.  16. 

11.  Kobcrt :  Ueber  Pilzvergif tung,  Dorpat,  1891. 


^. 


Ih  many  va- 

|re  are  many 

ranee.     The 

)oi8oning  is 

fungus,  be- 

jondition  of 


U  class  from 

BunsB  on  the 

[the  agarics. 

the  under 

The  flesh 

I  blue.     The 


